The present invention relates to an apparatus hereinafter called xe2x80x9csurgical extractorxe2x80x9d which is intended to be used in surgery, and more specifically in laparoscopy, to extract the gall-bladder or any other organ or element of a non-negligible size from the body of a patient during an operation.
There are numerous patents disclosing surgical extractors, which are devised to remove stones, tissues or other elements from the body of a patient. By way of examples, reference can be made to the following U.S. patents:
U.S. Pat. No. 4,807,626 (1989) McGIRR
U.S. Pat. No. 5,147,371 (1992) WASHINGTON
U.S. Pat. No. 5,788,709 (1998) RIEK et al
Some of these known extractors are specially adapted for a percutaneous use in vascular organs such as the lever or the kidneys, or in laparoscopy (see the WASHINGTON and RIEK et al patents).
There are also patents disclosing extractors that are medical but not surgical. By way of non-restrictive example of such patents, reference can be made to the following U.S. patent which discloses an extractor devised for removing faecal imprecations from the rectum of a patient:
U.S. Pat. No. 5,730,726 (1998) KLINGENSTEIN
There are furthermore numerous patents disclosing in apparatuses known as xe2x80x9csurgical retractorsxe2x80x9d, which are used for separating or spacing away part of an organ or of the body of a patient during a surgery, especially a laparoscopy. By way of non-restrictive examples of such patents, reference can be made to the following U.S. patents:
U.S. Pat. No. 5,275,610 (1994) EBERBACH
U.S. Pat. No. 5,339,803 (1994) MAYZELS et al
U.S. Pat. No. 5,656,012 (1997) SIENKIEWICZ
If all these patents disclose apparatuses having a structure and a utility that may a priori be considered as similar to those of the extractor according to the invention, none of them discloses a surgical extractor especially devised for use in laparoscopy, which, thanks to its structure, is devised:
1xe2x80x94to open on one side only of its longitudinal axis, in order to grasp and catch with more precision the organ to be extracted; and
2xe2x80x94to apply a substantial compression force onto the organ to be extracted after it has been grasped in order to crush it, grind it, if needs be, and thus reduce its size; and
3xe2x80x94to have an open internal tube that gives access not only to the extraction zone but also to the organ that is grasped in order to dissect it and suck it in.
Thus, the object to the invention is a device hereinafter called xe2x80x9csurgical extractorxe2x80x9d, which is intended to be used for extracting an organ from the body of a patient during an operation and which, thanks to its structure, satisfies the three needs listed hereinabove, thereby making it useful in particular in laparoscopy for extracting, through a tube of restricted diameter (one centimeter or less), organs that are of a not negligible size and, in fact, much larger than those of stones or tissues. By way of non-limitative example of such an organ of non-negligible size, reference can be made to the gallbladder.
The surgical extractor according to the invention is characterized in that it comprises:
a first hollow tube hereinafter called xe2x80x9cslidexe2x80x9d, said slide having a rectilinear longitudinal axis and a constant cross-section, a first open end and a second end, and a long radial opening close to the second end, said radial opening extending over more than half of the section of the slide; and
a second hollow tube hereinafter called xe2x80x9cpusherxe2x80x9d, which is mounted in a sliding manner over the slide.
Several flexible rods hereinafter called xe2x80x9cstrapsxe2x80x9d extend in line with the pusher. Each of the straps has a first end fixed in a rigid manner to the pusher and a second end connected in a rigid manner to the slide close to the second end of the same. These straps are distributed to extend over the radial opening of the slide.
Means are also provided for applying a pressure onto the pusher so as to:
in a first step, move the pusher over a given stroke distance from a rest position to an opening position closer to the second end of the slide, such causing the straps to fold up and open like petals over the radial opening and thus to allow grasping in a radial direction of an organ to be extracted from the body of the patient; and
in a second step, bring the pusher back from its opening position to its rest position while forcing, if needs be, the straps to unfold and thus crush the organ grasped by them, such permitting to the organ to pass inside the slide and thus to be extracted from the same through the first open end thereof.
The above mentioned means for applying a pressure onto the pusher preferably consist of handles respectively fixed to the slide and the pusher close to the first open end. By moving the handle of the pusher away from the one of the slide, one may move the pusher in the opening position. It is worth noting that the straps, due to their positioning, fold up above the opening and thus can be oriented in the radial direction mentioned hereinabove to allow directional grasping of the organ to be extracted. After such grasping, by moving the handles toward each other while pressing on them if needs be, one may move the pusher back in the rest position while crushing the organ grasped by the straps. If the crushing that is carried out is not sufficient to allow extraction of the organ, one may insert a knife through the slide because it is hollowed and opened at its first end, and thus one may cut or grind the organ in smaller parts that are capable of being extracted through the slide.
According to a preferred embodiment of the invention, the surgical extractor may incorporate a drill extending over the full length of the slide within the same for crushing and extracting the grasped organ. This bit may be driven in rotation by a motor located close to the first open end of the slide,
If needs be, a radial outlet may be provided close to the first open end of the slide, in order to connect it to a vacuum suction device.
In accordance with another preferred embodiment of the invention, a bag called xe2x80x9csealing bagxe2x80x9d provided of a radial slot, can be mounted onto the slide and straps in order to cover at least the radial opening and the second end of the slide. The slot of the bag is located so as to extend above the opening. When the pusher is moved in the opening position, the straps while they fold up, cause the slot to open and thus allow grasping of the organ that is then inserted within the bag. When the pusher is moved in the rest position, the bag is retracted together with the straps and avoids that the organ or crushed parts of it escape within the body of the patient.
Advantageously, a ring can be mounted in a sliding manner onto the pusher to maintain the sealing bag and permit to the operator to slide it in one way or the other depending on what is needed.
The invention and its advantages will be better understood upon reading the following non-limitative description that follows of several preferred embodiments thereof, mainly with reference to the accompanying drawings.